Updated September 2007
Planning for the Radiation Treatments: Mould Room and Simulator
Your treatment planning begins in our radiation therapy Mould Room. The appointment will last approximately 30 minutes. During this appointment, a thermoplastic mask will be made of your head. This involves taking a flat piece of thermoplastic and warming it up in a warm water bath. It will then be stretched over your face and head while you are lying down. It feels warm and wet initially and then the mask will start to harden in about 10 minutes. This mask will hold your head in position during each treatment.
An hour after you’ve had your mask made, you will have a CT scan done with the mask on. The images acquired during the scan, in addition to information and x-rays previously done, will be used by your radiation oncologist and the treatment planning therapists to develop your personalized treatment plan.
Treatments and Side Effects
Radiation treatments are given once a day, Monday to Friday, over several weeks. Most treatment appointments are between ten to twenty minutes. Most people do not experience any physical sensation during treatment. Your treatments do not make you radioactive.
The treatment may produce a variety of side effects. These depend on the amount of radiation given and the size and location of the area treated. They are due to swelling of the tissues in the brain. They include, but are not limited to, the following:
- Fatigue: Fatigue is a common side effect of radiation therapy. It usually starts towards the end of the second week of treatment. It can continue for 4-8 weeks, or longer, after treatment has finished. The degree of fatigue experienced varies with individuals. Patients having chemotherapy and radiation at the same time might experience more fatigue. It is possible to decrease this side effect and its impact on daily living. Drinking 8-10 glasses of non–caffeinated fluids a day is important when you are on treatment. Drinking helps flush out the effects of radiation that lead to cellular fatigue. To maintain energy, balance your activities. Walking for 20-30 minutes a day increases the brain chemicals endorphins that contribute to positive mood and energy. Modify but try to continue your normal physical activities. A short nap during the day may also be useful.
- Headache: Swelling in the brain can cause headaches which should be reported to a member of your health care team. This is very important if you have headaches in the morning or headaches associated with nausea and vomiting. If a preexisting headache becomes more severe or more frequent, this should also be reported. If you are taking Dexamethasone (Decadron), continue to do so as prescribed. The dosage may need to be adjusted and rapid control of symptoms can be expected. If you experience any sudden changes, contact your oncologist immediately.
- Nausea and Vomiting: Swelling in the brain can cause nausea and vomiting. Please report these or any worsening neurological symptoms to your health care team. Medications can be prescribed or existing medication dosages adjusted.
- Changes in Sensation and Movement: Contact your oncologist immediately if you experience any of the following: a change in vision, hearing or speech; a change in the feeling in the face, trunk, arms or legs; an abrupt change of bowel or bladder habit; weakness of the arms or legs; unsteady walk; seizure or "blackouts"; or any other changes. You may require important changes in your medication.
- Loss of Hair: Hair roots are very sensitive to radiation. Gradual hair loss from the area being treated will be noticed between four to six weeks after the start of radiation. This may be temporary (with re-growth within three to six months) or permanent, depending on the amount of radiation received. Skin care instructions will be given to you. Talk to your Registered Nurse about head coverings and wigs.
Dexamethasone (Decadron) is a widely used, effective medication which controls brain swelling. There are a number of side effects with this drug, which include increased appetite and weight gain; roundness of the face; stomach acid indigestion; easy bruising; hyperactivity and interference of sleep. Decadron can decrease the warning signs of infection, so any raised temperature or infection must be reported to your health care team. Decadron can also raise your blood sugar. If you are a diabetic or you have been told you are at risk for diabetes, your blood sugar must be monitored.
The lowest dose of Decadron for the shortest time will be used to minimize these side effects. You will be monitored and your Decadron dose adjusted during and after radiation treatment, as necessary. Decadron should not be stopped abruptly without consulting your doctor. Your Registered Nurse can give you an information sheet on Decadron.
Patients who have had a seizure are restricted, by law, from driving for 6 months. Patients with problems with their vision, strength, sensation or judgment may also need to stop driving. Your doctor will advise you about driving. Ask your health care team about volunteer drivers.
An appointment will usually be arranged for four to six weeks after your last treatment. Medical, social and rehabilitation needs will be assessed then.